Relationship between hepatitis B surface antigen, HBV DNA quantity and liver fibrosis severity / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To explore the correlation between serum hepatitis B surface antigen (HBsAg) level and hepatic tissue pathological staging in patients with chronic hepatitis B (CHB).</p><p><b>METHODS</b>Clinical data was collected from our hospital's records for 302 CHB patients with HBsAg-positive status for more than 6 months and who had undergone hepatic biopsy. The HBsAg level,HBV DNA level and other clinical data were measured using commercial diagnostic assays. Liver histology was scored using the GS staging system. Correlation between serum HBsAg quantity, HBV DNA quantity, stage of inflammation and degree of fibrosis was assessed statistically.</p><p><b>RESULTS</b>The correlation of serum HBsAg level and HBV DNA level was notable. The serum HBsAg level was a variable affecting hepatic tissue pathological stage significantly. Serum HBsAg level appeared to be a highly specific and sensitive diagnostic marker of hepatic fibrosis. As the severity of liver fibrosis increased, the quantitative levels of platelet (PLT), HBsAg and HBV DNA gradually decreased, and the APRI index gradually increased; there were significant differences between the groups (all P<0.001). Serum HBsAg and HBV DNA levels in patients with hepatitis B e antigen-positive (HBeAg(+)) status showed strong correlation (r=0.721, P<0.0001) by Spearman analysis. HBeAg(+) patients with moderate to severe fibrosis (S2-4) exhibited significantly lower serum HBsAg and HBV DNA levels compared with patients with no or mild fibrosis (S0-1; t=5.475 and 4.826, P<0.001). ROC analysis suggested that a serum HBsAg cutoff of 4.46 log 10 IU/mL (28 800 IU/mL) would provide a theoretical sensitivity of 76.3%, with theoretical specificity of 70.5% in HBeAg(+) CHB patients. A serum HBV DNA cutoff of 7.13 log 10 IU/mL (1.35*10(7) copies/mL) would provide a theoretical sensitivity of 71.1%, with theoretical specificity of 73.4% in HBeAg(+) CHB patients. Logistic regression analysis showed that the level of HBsAg was an independent prognostic factor of moderate to severe liver fibrosis, with alanine aminotransferase, aspartate aminotransferase, HBsAg, HBV DNA and PLT (P<0.001).</p><p><b>CONCLUSION</b>HBsAg and HBV DNA levels decrease gradually along with aggravation of liver fibrosis. The cutoff values of 28800 IU/mL for HBsAg and 1.35*10(7) copies/mL ofHBV DNA provide higher specificity and sensitivity for predicting the degree of liver fibrosis in HBeAg-positive CHB patients, and the former is an independent predictor of severe liver fibrosis.</p>

Quantitation value of HBsAg in different clinical stages of chronic hepatitis B virus infection / 实用医学杂志

Objective To investigate the levels of HBsAg and HBV DNA in different clinical stages. Methods Serum samples of 246 patients, without accepting antiviral therapy, from the second affiliated anhui medical univrsity were collected from 2012.1 to 2013.5. Among the enrolled patients, 41 cases with chronic HBV-carrier (ASC), 99 cases with chronic hepatitis B patients (CHB), 70 cases with liver cirrhosis (LC), and 36 cases with primary liver cancer (HCC) were included. Results Levels of HBsAg in the group of ASC, CHB, LC, HCC were 135 280.00 (1 788.80 ~ 51 820.00) IU / mL, 8 218.00 (1 644.60 ~ 266 700.80) IU / mL, 1 280.38 (265.70~2 375.00) IU / mL, and 925.10(135.05 ~ 2 381.8) IU / mL, respectively. Positive correlations were observed between HBsAg tire and HBV DNA levels (rs = 0.332, P = 0.000), and negative correlations were doserved between HBsAg leve and age(rs = -0.496,P = 0.000). Conclusions The level of HBsAg in serum decreased progressively from the group of ASC to CHB, LC and HCC, the positive correlation between levels of HBsAg and HBV DNA, and the negative correction between HBsAg level and age were demonstrated.

Expression of interleukin-18 in liver tissue of patients with chronic hepatitis B and its clinical significance / 中华临床感染病杂志

Objective To investigate the expression of interleukin 18 (IL-18) in liver tissues of patients with chronic hepatitis B (CHB) and its clinical significance.Methods Totally 172 CHB patients admitted in the Second Affiliated Hospital of Anhui Medical University from January 2012 to December 2012 were enrolled.The tissue specimens were obtained by liver biopsy from all patients,and 22 normal liver specimens were also collected as controls.Liver function,serum markers of HBV and HBV DNA load were measured and liver inflammation grades and fibrosis stages were assessed.Immunohistochemical method was used to detect the expression of IL-18 in liver tissues.Spearman rank correlation was used to analyze the correlations between IL-18 expression and the above indicators.Results IL-18 was mainly expressed in cytoplasm of liver cells.It was positive or strong positive in liver cells of healthy people,but weakly positive in liver cells of CHB patients.The difference of IL-18 expression between CHB patients and healthy people was of statistical significance (x2 =42.124,P ＜ 0.05).In CHB patients,the expression of IL-18 was gradually enhanced with the increasing of ALT,inflammation grades and fibrosis stages (r =0.182,0.173 and 0.068,P ＜0.05),but it was not correlated with HBV DNA load and HBeAg (r =-0.05 and 0.041,P ＞0.05).Conclusion In CHB patients,the expression of IL-18 may be involved in liver injury and fibrosis formation.